Individual provider Active NPI

Paul Lange, PT, DPT, ATC

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1578247268
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42924 Issued in FL
Practice address
7901 Baymeadows Way Ste 5
Jacksonville, FL 32256-8535
Phone
(904) 414-3796
NPI assigned
Jun 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X ATTL-000409 AZ
Physical Therapist 225100000X 42924 FL Primary

Addresses

Primary practice location

7901 Baymeadows Way Ste 5
Jacksonville, FL 32256-8535

Mailing address

311 E Embassy St
Tempe, AZ 85288-1315
Phone (904) 710-8026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250519002508 FL Practitioner - Physical Therapist in Private Practice 4082132501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Rehabilitation, LLCGroup PAC ID 6901884519, 20 clinicians

Practice addresses (Care Compare)

495 S Nova Rd
Suite 113
Ormond Beach, FL 32174-8470
Phone (386) 677-4300

733 Dunlawton Ave
Suite 103
Port Orange, FL 32127-4226
Phone (386) 756-0077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42924FLMDPhysical Therapist
ATTL-000409AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Motion RX Health and Performance PLLC Physical Therapist CurrentSince Apr 26, 2025 Accepting new patients
University Rehabilitation, LLC Physical Therapist CurrentSince Sep 7, 2025 Accepting new patients

Locations

7901 Baymeadows Way
Ste 5
Jacksonville, FL 32256
Phone (904) 414-3796

733 Dunlawton Ave
Ste 103
Port Orange, FL 32127
Phone (386) 756-0077

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1578247268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E EMBASSY ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852881315",
            "telephone_number": "904-710-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BAYMEADOWS WAY STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568535",
            "telephone_number": "904-414-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "PAUL",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-13",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "ATTL-000409",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "42924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.